President of the High Court Mr Justice Peter Kelly described what happened as being "substandard" and "regrettable".

He was told the woman is to be fed by an alternative programme to tube feeding through her stomach - which the hospital had decided not to recommend because she was not fit to take it. She will now undergo what is known as comfort feeding, involving her being fed small amounts of certain foods orally.

On Monday, the judge directed an urgent inquiry into whether the treatment which the hospital had proposed was medically justifiable.

The HSE, in its apology to the woman's family, said a care plan compiled by a multi-disciplinary team was not communicated to the woman's GP or the nursing home to which she had been discharged at 4am.

The manner in which she had been discharged from the hospital to a nursing home was substandard, and should not have happened, counsel for the HSE Sarah McKecknie said.

All the nursing home and the GP received was a discharge summary from the hospital.

The woman, who has dementia, recently lost the ability to swallow because of a stroke, but is otherwise healthy. She was hospitalised in early January with aspirational pneumonia.

She was discharged from the hospital late last week at 4am and was returned to a nursing home where she had previously been resident.

Mr Justice Kelly said in this case there had not been proper communication between the hospital and the GP and the nursing home concerning the woman, and about the care plan that had been put in place.

Noting that the HSE had apologised several times, the judge also hoped there would be agreement between the parties concerning the woman's ongoing treatment.

The "urgent" situation the court found itself presented with was something "I hope will not be repeated", he said.

The woman's son told the court the family had no problem with the hospital and accepted they had been informed about the risks of the tube-feeding procedure. Their main concern was that she would be comfortable and not in pain.

The judge, in adjourning the matter to this Friday, said that he hoped any remaining difficulties between the parties concerning the woman's health are resolved.

If not, he was minded to appoint a visiting physician to independently assess the woman on the court's behalf.